Swallowing is a complex physiological process involving multiple muscles and cranial nerves working together in a timely manner for a safe and efficient swallow.
“Dysphagia” is the medical term for disturbances in feeding and swallowing. Dysphagia can occur in people of all ages, but occurs most often in the very young or the elderly. One may have difficulty swallowing or may feel pain during the swallow. An individual with dysphagia may not be able to swallow at all or may have difficulty swallowing liquids, solids and even their own saliva due to weakness and/or incoordination of the muscles in and around the face, mouth and neck. Persistent dysphagia can result in a medical diagnosis of "failure to thrive" in which a person is unable to reach or maintain adequate food or hydration resulting in medical complications from malnutrition and/or dehydration. In children, this can result in general developmental delays.
Dysphagia is often classified as mild, moderate or severe and can either occur in one isolated phase or encompass multiple phases of the swallow simultaneously.
A normal swallow occurs over three phases/stages:
1. The oral phase encompasses the biting, chewing, bolus (food) preparation and formation and transit of the bolus from the front of the oral cavity (mouth) to the rear for swallowing. Deficits in this stage are referred to as oral dysphagia.
2. The pharyngeal phase refers to the phase of the swallow where the bolus leaves the oral cavity and enters the pharynx on its way to the esophagus. In layman's terms this is the phase where the food goes down the throat. Problems during this stage are termed pharyngeal dysphagia.
3. The esophageal phase refers to the stage during which the bolus enters the esophagus and, via a series of muscular contractions known as "peristalsis", eventually reaches the stomach. Any difficulty that may arise during this phase is called esophageal dysphagia.
For a great detailed animation of the information presented above, go to:
For a patient's perspective on severe dysphagia, see the video below.
Dysphagia Therapy focuses on improving strength and coordination of the muscles. In addition, dysphagia therapy also encompasses training an individual to use compensatory strategies to help resolve or lessen the symptoms of dysphagia.
Please see the VitalStim Therapy section of this site for additional information on dysphagia therapy.